Evaluation of meaningful recognition programs in three colleges of nursing.

BACKGROUND: The nursing faculty shortage in the United States presents a challenge to maintaining a robust healthcare workforce. Meaningful recognition (MR) is an evidence-based practice that improved nurse burnout (BO) in the clinical setting. There is limited literature on its impact on nurse faculty. PURPOSE: Three colleges of nursing implemented The DAISY Diseases Attacking the Immune SYstem Award for Extraordinary Nursing Faculty as an MR program to improve compassion satisfaction (CS) and BO among nursing faculty. METHODS: This project employed a pre- and post-survey design to assess changes in faculty CS, BO, and secondary traumatic stress using the ProQOL Professional Quality of Life version 5. DISCUSSION: The results suggest that while the implementation of MR programs did not significantly alter these metrics, the faculty maintained stable levels of CS despite the stressful COVID-19 pandemic. CONCLUSION: Additional research is needed to explore the potential for MR to mitigate faculty BO.

An analytical cross-sectional study on the association between animal companionship and anxiety among students of a private medical school in Quezon City / The Health Sciences Journal

Introduction@#Constant stress predisposes medical students to anxiety. The study aimed to determine the association between animal companionship and anxiety among medical students at UERMMMCI.@*Methods@#The study utilized an analytical cross-sectional design via an online form with the anxiety portion of the HADS questionnaire. Participants included first to third year medical students of a private medical school.@*Results@#A total of 161 responses were recorded. Sex and year-level exhibited significant association with anxiety. Those with anxiety were 2.71 times more likely to be females (p = 0.007). Stratification showed that those with anxiety were 1.72 times less likely to be females with pets (p = 0.37) while, in contrast, those with anxiety were 3.64 times more likely (p = 0.02) to be males with pets. Those with anxiety were likely to belong to first and second-years (p = 0.01 and p = 0.06), respectively and pet owners, though, not statistically significant (p = 0.357).@*Conclusion@#An association between sex and year-level with anxiety was noted. Those with anxiety were likely to be females, first-years, and males with animal companionship. Although they did not reach statistical significance.

Glucosinolates and Omega-3 Fatty Acids from Mustard Seeds: Phytochemistry and Pharmacology.

Seeds from mustard (genera Brassica spp. and Sinapsis spp.), are known as a rich source of glucosinolates and omega-3 fatty acids. These compounds are widely known for their health benefits that include reducing inflammation and lowering the risk of cardiovascular diseases and cancer. This review presented a synthesis of published literature from Google Scholar, PubMed, Scopus, Sci Finder, and Web of Science regarding the different glucosinolates and omega-3 fatty acids isolated from mustard seeds. We presented an overview of extraction, isolation, purification, and structure elucidation of glucosinolates from the seeds of mustard plants. Moreover, we presented a compilation of in vitro, in vivo, and clinical studies showing the potential health benefits of glucosinolates and omega-3 fatty acids. Previous studies showed that glucosinolates have antimicrobial, antipain, and anticancer properties while omega-3 fatty acids are useful for their pharmacologic effects against sleep disorders, anxiety, cerebrovascular disease, neurodegenerative disease, hypercholesterolemia, and diabetes. Further studies are needed to investigate other naturally occurring glucosinolates and omega-3 fatty acids, improve and standardize the extraction and isolation methods from mustard seeds, and obtain more clinical evidence on the pharmacological applications of glucosinolates and omega-3 fatty acids from mustard seeds.

Low-cost 3D modeling software for generating patient-specific drill guide templates for cervical pedicle screw insertion: An in vitro study

BACKGROUND@#Instrumented posterior cervical spine surgery (IPCSS) can be conducted using screws inserted through the pedicles of the vertebra. A safe IPCSS method uses 3D-printing to produce templates that will serve as drill guides for screw placement.@*OBJECTIVES@#This study describes the generation of 3D-printed drill guides using low-cost general purpose 3D modeling software and the comparison of screw insertion accuracy scores against the traditional landmark method and guides created using commercial grade software.@*METHODS@#Twenty-five (25) subaxial pedicles of five cadaveric spines were selected and scanned using computed tomography (CT). A digital reconstruction of the five cadaveric spines were created based on the CT DICOM data. A low-cost 3D modeling software, Rhinoceros 3D, was utilized for trajectory planning and generation of a patientspecific drill template using the digital reconstruction. The templates were then fabricated in ABS plastic using a fused deposition modeling (FDM) 3D printer. Insertion of cervical pedicle screws on the cadaveric spines was done by an orthopedic resident using the 3D printed guides. Postoperative CT scans were obtained, and placement accuracy of the screws were scored by two assessors utilizing a four-point rating system. Screws in correct placement were scored Grade 0 while misplaced screws with neurovascular damage were given a score of Grade 3.@*RESULTS@#Accuracy scores for the 3D-printed drill guides were 52% for assessor 1 and 44% for assessor 2. For assessor 1, screw placement in C3, C6, and C7 received the highest scores. For assessor 2, the highest scores were achieved in C3 and C7. The hybrid method of Bundoc et al. achieved scores of 94% while 3D printed guides utilizing commercial software like Materialise Mimics, Geomagic Freeform, or UG Imageware achieved scores of 80-100%. The traditional landmark method had scores ranging from 12% to 94% depending on the skill of the surgeon.@*CONCLUSION@#Commercial medical 3D image-based engineering software has high acquisition costs that might be beyond the reach of most institutions. A sub-$1000 general purpose 3D modeling software can be used to create drill templates. Several factors were identified in the design and fabrication of the template that can be addressed to increase accuracy. Trajectory planning can also be improved by automating the process. The researchers recommend further studies in these areas specially in the context of developing 3D printing as a support service for surgical operations in the Philippines.

Plant Species of Sub-Family Valerianaceae-A Review on Its Effect on the Central Nervous System.

Valerianaceae, the sub-family of Caprifoliaceae, contains more than 300 species of annual and perennial herbs, worldwide distributed. Several species are used for their biological properties while some are used as food. Species from the genus Valeriana have been used for their antispasmodic, relaxing, and sedative properties, which have been mainly attributed to the presence of valepotriates, borneol derivatives, and isovalerenic acid. Among this genus, the most common and employed species is Valerianaofficinalis. Although valerian has been traditionally used as a mild sedative, research results are still controversial regarding the role of the different active compounds, the herbal preparations, and the dosage used. The present review is designed to summarize and critically describe the current knowledge on the different plant species belonging to Valerianaceae, their phytochemicals, their uses in the treatment of different diseases with particular emphasis on the effects on the central nervous system. The available information on this sub-family was collected from scientific databases up until year 2020. The following electronic databases were used: PubMed, Scopus, Sci Finder, Web of Science, Science Direct, NCBI, and Google Scholar. The search terms used for this review included Valerianaceae, Valeriana, Centranthus, Fedia, Patrinia, Nardostachys, Plectritis, and Valerianella, phytochemical composition, in vivo studies, Central Nervous System, neuroprotective, antidepressant, antinociceptive, anxiolytic, anxiety, preclinical and clinical studies.

On the Correlation between Light-Induced Degradation and Minority Carrier Traps in Boron-Doped Czochralski Silicon.

Boron-doped Czochralski-grown silicon wafers dominate the photovoltaic market. Light-induced degradation of these wafers is one of the most significant roadblocks for high-efficiency solar cells. Despite a very large number of publications on this topic, only a few studies have directly investigated the precursor of the defect responsible for this degradation. In this study, using the photoconductance decay measurement method, we identify the precursor of the defect responsible for light-induced degradation. By comparing the photoconductance decay of samples in the different states, we observe the presence of a minority carrier trap in the annealed state, which is not present after degradation. Trap annihilation shows a clear anticorrelation with the generation of the recombination-active boron-oxygen defect, as determined from minority carrier lifetime measurements. Furthermore, it is concluded that a model based on a single-level trap cannot explain the doping-dependent measurements, meaning that the detected trap has two or more energy levels.

The Effects of Two Community-Based Participatory Action Research Programs on Violence Outside of and in School Among Adolescents and Young Adults in a Latino Community.

PURPOSE: Violence is the leading cause of death among adolescents and young adults in the Americas. Community-Based Participatory Action Research engaged youth and parents to develop and implement two interventions. A Violence Prevention Program (VPP) focused on risk factors for violence, and a Positive Youth Development Program (PYDP) focused on protective factors. Program effects on violence outside of and in school were assessed at 6 and 12 months. METHODS: Both interventions included an 8-week internet-based program and an in-person youth summit. Participants were prospectively randomized twice, first to the VPP and a no-VPP control group and again to the PYDP and a no-PYDP control group. Participants self-reported violence outside of and in school through self-administered baseline surveys with repeat assessments at 6 and 12 months. Analysis of covariance models examined VPP and PYDP effects on violence. RESULTS: The analysis sample was 86% Latino, 56% female, 36% aged 10-13 years, 45% aged 14-18, and 19% aged 19-23 years. Analysis of covariance models of violence outside of school demonstrated small program interaction effects at 6 months (partial eta2 = .030; p = .007) and small VPP effects at 12 months (partial eta2 = .023; p = .025). Models of violence in school demonstrated small PYDP effects at 6 months (partial eta2 = .023; p = .018). CONCLUSIONS: Community-Based Participatory Action Research engaging adolescents, young adults, and parents to address locally relevant health issues can have multiple benefits. In this study, a VPP had positive effects on violence outside of school at 12 months, and a PYDP had positive effects on violence in school at 6 months.

Seven-Year Experience From the National Institute of Neurological Disorders and Stroke-Supported Network for Excellence in Neuroscience Clinical Trials.

Importance: One major advantage of developing large, federally funded networks for clinical research in neurology is the ability to have a trial-ready network that can efficiently conduct scientifically rigorous projects to improve the health of people with neurologic disorders. Observations: National Institute of Neurological Disorders and Stroke Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT) was established in 2011 and renewed in 2018 with the goal of being an efficient network to test between 5 and 7 promising new agents in phase II clinical trials. A clinical coordinating center, data coordinating center, and 25 sites were competitively chosen. Common infrastructure was developed to accelerate timelines for clinical trials, including central institutional review board (a first for the National Institute of Neurological Disorders and Stroke), master clinical trial agreements, the use of common data elements, and experienced research sites and coordination centers. During the first 7 years, the network exceeded the goal of conducting 5 to 7 studies, with 9 funded. High interest was evident by receipt of 148 initial applications for potential studies in various neurologic disorders. Across the first 8 studies (the ninth study was funded at end of initial funding period), the central institutional review board approved the initial protocol in a mean (SD) of 59 (21) days, and additional sites were added a mean (SD) of 22 (18) days after submission. The median time from central institutional review board approval to first site activation was 47.5 days (mean, 102.1; range, 1-282) and from first site activation to first participant consent was 27 days (mean, 37.5; range, 0-96). The median time for database readiness was 3.5 months (mean, 4.0; range, 0-8) from funding receipt. In the 4 completed studies, enrollment met or exceeded expectations with 96% overall data accuracy across all sites. Nine peer-reviewed manuscripts were published, and 22 oral presentations or posters and 9 invited presentations were given at regional, national, and international meetings. Conclusions and Relevance: NeuroNEXT initiated 8 studies, successfully enrolled participants at or ahead of schedule, collected high-quality data, published primary results in high-impact journals, and provided mentorship, expert statistical, and trial management support to several new investigators. Partnerships were successfully created between government, academia, industry, foundations, and patient advocacy groups. Clinical trial consortia can efficiently and successfully address a range of important neurologic research and therapeutic questions.

Every second counts: A retrospective case series on patients of a tertiary hospital psychiatry unit who underwent electroconvulsive therapy from September 2015 to August 31, 2016

@#This research aimed to describe the demographic and clinical presentation over the course of hospital stay of all patients who underwent at least 6 sessions of electroconvulsive therapy (ECT) from September 1, 2015 to August 31, 2016. METHODOLOGY: This was a retrospective case series. After extensive inclusion and exclusion criteria were employed, seven out of the 13 patients given ECT that year were included for this study (n=7). This was comprised of: three (n=3) with MDD, two (n=2) with Bipolar Disorder Most Recent Episode (MRE) Depressed, two (n=2) with schizophrenia spectrum disorders. For these cases, they were all initially recommended to undergo 6 ECT sessions. All underwent the same anesthetic technique, performed by the same anesthesiologist. Comparison of their course during treatment was obtained through chart review and through recorded DSM-5 symptom checker accomplished on their admission, after 4th ECT session, after the last ECT session and 24 hours before discharge. RESULTS: Only cases with MDD were in their early adulthood (n=2) showed reduction of symptoms 24 hours after the 4th ECT session and did not require further sessions or any changes in the placement of the ECT leads. In contrast, two (n=2) of the cases who were women in their late adulthood required a shift from an initial unilateral ECT to bilateral ECT after no improvement was noted in their 4th session, thereby requiring more sessions than planned. Cases with other diagnoses (n=4) also required more sessions than initially planned and did not show improvement in their symptom checkers 24 hours after the 4th ECT session. Findings and how each case compared with current literature on the understanding of ECT and factors such as age, gender, diagnosis, history of psychopathology, lead placement, were further explored in the discussion. CONCLUSION: The study shows that there was significant reduction in symptoms during the course of admission among patients receiving ECT at the tertiary institution of study; however, the course of symptom reduction varied based on several factors. Factors discussed in this study were age, biological sex, history of psychopathology, diagnosis and ECT lead placement. Due to the limited number of cases,, it is recommended for future researchers to compare symptomatology of patients and their clinical course during the duration of ECT treatment for a longer period of time and with a larger sample size in order to arrive at a more generalizable protocol.

Measurement of the IgM and IgG Autoantibody Immune Responses in Human Serum has High Predictive Value for the Presence of Colorectal Cancer.

INTRODUCTION: Colorectal cancer is a major public health issue, with incidences continuing to rise owing to the growing and aging world population. Current screening strategies for colorectal cancer diagnosis suffer from various limitations, including invasiveness and poor uptake. Consequently, there is an unmet clinical need for a minimally invasive, sensitive, and specific method for detecting the presence of colorectal cancer and pre-malignant lesions. PATIENTS AND METHODS: An indirect enzyme-linked immunosorbent assay was used to measure the primary (IgM) and secondary (IgG) adaptive humoral immune responses to a panel of previously identified cancer antigens in the sera of normal and adenoma samples, and sera from patients with colorectal cancer. RESULTS: An optimal panel of 7 biomarkers capable of identifying patients with colorectal cancer as distinct from both normal and adenoma samples is identified. The cumulative sensitivity and specificity of the assay are 70.8% and 86.5%, respectively. The positive and negative predictive values of the cohort are 77.3% and 82.1%. This assay was not able to accurately discriminate between normal and adenoma samples. Patients whose serum was positive for the presence of anti-ICLN IgM autoantibodies had a significantly poorer 5-year survival than patients whose serum was negative (P = .004). CONCLUSION: This study describes a novel minimally invasive enzyme-linked immunosorbent assay-based method, capable of identifying patients with colorectal cancer as distinct from both normal and adenoma samples. Patients are likely to be far more amenable to a blood-based test such as the one described herein, rather than a fecal-based test, likely leading to increased patient uptake.

Neurobehavioral consequences of continuous spike and waves during slow sleep (CSWS) in a pediatric population: A pattern of developmental hindrance.

INTRODUCTION: Continuous spike and waves during slow sleep (CSWS) is a typical EEG pattern defined as diffuse, bilateral and recently also unilateral or focal localization spike-wave occurring in slow sleep or non-rapid eye movement sleep. Literature results so far point out a progressive deterioration and decline of intellectual functioning in CSWS patients, i.e. a loss of previously normally acquired skills, as well as persistent neurobehavioral disorders, beyond seizure and EEG control. The objective of this study was to shed light on the neurobehavioral impact of CSWS and to identify the potential clinical risk factors for development. METHODS: We conducted a retrospective study involving a series of 16 CSWS idiopathic patients age 3-16years, considering the entire duration of epilepsy from the onset to the outcome, i.e. remission of CSWS pattern. All patients were longitudinally assessed taking into account clinical (sex, age at onset, lateralization and localization of epileptiform abnormalities, spike wave index, number of antiepileptic drugs) and behavioral features. Intelligent Quotient (IQ) was measured in the whole sample, whereas visuo-spatial attention, visuo-motor skills, short term memory and academic abilities (reading and writing) were tested in 6 out of 16 patients. RESULTS: Our results showed that the most vulnerable from an intellectual point of view were those children who had an early-onset of CSWS whereas those with later onset resulted less affected (p=0.004). Neuropsychological outcome was better than the behavioral one and the lexical-semantic route in reading and writing resulted more severely affected compared to the phonological route. CONCLUSIONS: Cognitive deterioration is one but not the only consequence of CSWS. Especially with respect to verbal skills, CSWS is responsible of a pattern of consequences in terms of developmental hindrance, including slowing of development and stagnation, whereas deterioration is rare. Behavioral and academic problems tend to persist beyond epilepsy resolution.

The anti-asthmatic effect of the combined yerba buena (Mentha arvensis Linn.) and oregano (Coleus amboinicus Lour.) leaves in BALB/c mice model of allergic asthma

INTRODUCTION: Asthma is an IgE-mediated inflammatory response characterized by hyperresponsiveness, airway inflammation, and reversible airflow obstruction. Currently, asthma affects 12 - 22% of the population in the Philippines. Anecdotal reports showed that yerba buena (Mentha arvensis Linn.) and oregano (Coleus amboinicus Lour.) are utilized for treating asthma in the folk culture.OBJECTIVE: The objective of this study was to determine the effect of combined Yerba Buena (Mentha arvensis Linn.) and Oregano (Coleus amboinicus Lour.) leaves extract in asthma-induced mice.METHODS:This study investigated the anti-asthmatic activity of the aqueous and methanolic extracts of the combined herbs in asthma-induced mice using immunoglobulin E (IgE) as a parameter.RESULTS: Aqueous- and methanol-treated mice has 50% and 60% reduction in the IgE level, respectively (p = 0.018). The extracts exhibited a significant (p = 0.001) anti-inflammatory activity in mice that further proved its effect on IgE. Moreover, lung histopathology also established the potential effect of the extract through the widening of the alveoli on treated mice.CONCLUSION: Combined Yerba Buena and Oregano aqueous and methanol extracts may have a potential health benefit against asthma.

Systemic lupus erythematosus with coexistent psoriasis vulgaris: A case report

@#<p style="text-align: justify;">We report a 42-year-old female with a 20-year history of systemic lupus erythematosus who subsequently developed psoriasis vulgaris. She has been on chronic, erratic prednisone and hydroxychloroquine intake prior to appearance of psoriatic lesions. Hydroxychloroquine and glucocorticoids are possible triggers of this phenomenon. Both diseases have a shared susceptibility loci and a shared Th17 pathophysiologic pathway.Treatment with methotrexate and selected biologics can target both disease mechanisms.</p>

End-of-Life planning among older Filipinos

Purpose@#The number of older Filipinos continues to rise resulting in increasing numbers of people who live in a modernized world which offers numerous options to prepare for the End-of-Life (EoL). Henceforth, EoLplanning among older Filipinos and the factors which could potentially influence the propensity to plan ahead needs further investigation. This study ascertained the level of health, relationship, funerary, legal and financial-related EoL planning among older Filipinos, and established the association between EoL planning and sex, chronologic age, religious affiliation, ethnicity, health and financial status.@*Methods@#The study utilized a descriptive survey design, including 400 respondents, chosen through purposive sampling and met the inclusion of Filipino, Baguio residents, aged 60 and above, able to read and understand English, Filipino or Ilokano, and without psychological disturbances or cognitive deficits. The researchers used a self-made questionnaire after establishing validity (0.96) and reliability (0.82). The Saint Louis University Research Ethics Committee ensured the ethical conduct of this research. Data were treated with statistics using frequency, mean and Chi-square test.@*Findings@#The responses indicated moderate levels of EoL planning overall. Moreover, statistical tests revealed that only health status has a significant association with EoLplanning.@*Conclusions@#Based on the findings, the researchers conclude that EoL planning remains not widely used in the Philippines, thus, intensifying the call for more aggressive interventions to make EoL planning salient and acceptable to older people. In addition, health status affects EoL planning considerably, and that knowing the sex, chronologic age, religious affiliation, ethnicity and financial status did not help predict EoLplanning.

The anti-asthmatic effect of the combined yerba buena (Mentha arvensis Linn.) and oregano (Coleus amboinicus Lour.) leaves in BALB/c mice model of allergic asthma

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Asthma is an IgE-mediated inflammatory response characterized by hyperresponsiveness, airway inflammation, and reversible airflow obstruction. Currently, asthma affects 12 - 22% of the population in the Philippines. Anecdotal reports showed that yerba buena (Mentha arvensis Linn.) and oregano (Coleus amboinicus Lour.) are utilized for treating asthma in the folk culture.<br /><strong>OBJECTIVE:</strong> The objective of this study was to determine the effect of combined Yerba Buena (Mentha arvensis Linn.) and Oregano (Coleus amboinicus Lour.) leaves extract in asthma-induced mice.<br /><strong>METHODS:</strong>This study investigated the anti-asthmatic activity of the aqueous and methanolic extracts of the combined herbs in asthma-induced mice using immunoglobulin E (IgE) as a parameter.<br /><strong>RESULTS:</strong> Aqueous- and methanol-treated mice has 50% and 60% reduction in the IgE level, respectively (p = 0.018). The extracts exhibited a significant (p = 0.001) anti-inflammatory activity in mice that further proved its effect on IgE. Moreover, lung histopathology also established the potential effect of the extract through the widening of the alveoli on treated mice.<br /><strong>CONCLUSION:</strong> Combined Yerba Buena and Oregano aqueous and methanol extracts may have a potential health benefit against asthma.</p>

The changing face of dietary therapy for epilepsy.

UNLABELLED: Ketogenic diet is an established and effective non-pharmacologic treatment for drug-resistant epilepsy. Ketogenic diet represents the treatment of choice for GLUT-1 deficiency syndrome and pyruvate dehydrogenase complex deficiency. Infantile spasms, Dravet syndrome and myoclonic-astatic epilepsy are epilepsy syndromes for which ketogenic diet should be considered early in the therapeutic pathway. Recently, clinical indications for ketogenic diet have been increasing, as there is emerging evidence regarding safety and effectiveness. Specifically, ketogenic diet response has been investigated in refractory status epilepticus and encephalopathy with status epilepticus during sleep. New targets in neuropharmacology, such as mitochondrial permeability transition, are being studied and might lead to using it effectively in other neurological diseases. But, inefficient connectivity and impaired ketogenic diet proposal limit ideal availability of this therapeutic option. Ketogenic diet in Italy is not yet considered as standard of care, not even as a therapeutic option for many child neurologists and epileptologists. CONCLUSIONS: The aim of this review is to revisit ketogenic diet effectiveness and safety in order to highlight its importance in drug-resistant epilepsy and other neurological disorders. WHAT IS KNOWN: • Ketogenic diet efficacy is now described in large case series, with adequate diet compliance and side effects control. • Ketogenic diet is far from being attempted as a first line therapy. Its availability varies worldwide. What is New: • New pharmacological targets such as mitochondrial permeability transition and new epileptic syndromes and etiologies responding to the diet such as refractory status epilepticus are being pointed out. • Ketogenic diet can function at its best when used as a tailor-made therapy. Fine tuning is crucial.

Family function and level of caregiver strain among diabetic patients at the outpatient clinic of Ospital ng Maynila Medical Center

Diabetes Mellitus is a chronic illness that needs to be addressed holistically to prevent the development of complications among diabetic patients. Hence, factors that can help in the management of diabetic patients to prevent further damage to their organs must be dealt with. One of these factors involves the relationship of the patient to its family members. Caregivers, on the other hand also play significant role in patients with chronic illnesses, thus were also emphasized in this study. Thus relationship of patients and caregivers with their families was measured through the Family APGAR 1, while the level of caregiver strain was measured through the Modified Caregiver Strain Index. A total of 79 diabetic patients and their respective caregivers took part in the study. The average age of diabetic patients was 63 years old. The average number of years having diabetes was 11.61 years. Majority of the patients were female (60.76%), had co-morbidities (67.09%) and were both on oral medication and insulin injection (60.76%). On the other hand, the average age of caregivers, attending to the diabetic patients was 50 years. The average number of years as caregivers attending to the diabetic patients was 8.3 years. Majority of the caregivers were female (82.28%). Almost half of them were the spouses of the patients. Caregivers o had some elementary education or had completed (40.51%) it and those who had some high school education or had completed it (40.51%). Forty three percent of the caregivers provided the patient oral medication alone and 31.65% gave both oral medication and insulin injection. Based on the results of the Family APGAR 1 of the diabetic patients, 10.13% of them were moderately dysfunctional and 89.87% were highly functional. No patient earned an APGAR score equivalent to the 'Severely Dysfunctional'. More than half of the caregivers (68.35%) had highly functional relationship with their families; 29.11% were moderately dysfunctional, and only 2.53% were severely dysfunctional. In terms of the level of caregiver strain it was illustrated that approximately 95% of the caregivers scored low on the Modified Caregiver Strain Index which implies that majority of the caregivers were still far from suffering from caregiver strain. 

The Child Concentration Inventory (CCI): Initial validation of a child self-report measure of sluggish cognitive tempo.

Sluggish cognitive tempo (SCT) is characterized by excessive daydreaming, mental confusion, slowness, and low motivation. Several teacher- and parent-report measures of SCT have recently been developed but a child self-report measure of SCT does not yet exist despite clear links between SCT and internalizing psychopathology (for which self-report is often desired). This study examined the initial reliability and validity of the Child Concentration Inventory (CCI), a child self-report measure of SCT symptoms, in a school-based sample of 124 children (ages 8-13; 55% female). Children completed the CCI and measures of academic/social functioning, emotion regulation, and self-esteem. Teachers completed measures of psychopathology symptoms (including SCT) and academic/social functioning. Although exploratory structural equation modeling (ESEM) supported a 3-factor model of the CCI (consisting of slow, sleepy, and daydreamer scales closely resembling the factor structure of the parent-report version of this measure), bifactor modeling and omega reliability indices indicated that the CCI is best conceptualized as unidimensional. CCI scores were significantly correlated with teacher-rated SCT and were statistically distinct from teacher-rated ADHD and child-rated anxiety/depression. After controlling for sex, grade, and other psychopathology symptoms, the CCI total score was significantly associated with poorer child-reported academic/social functioning and self-worth in addition to increased loneliness and emotion dysregulation. Child ratings on the CCI were moderately to strongly correlated with poorer teacher-rated academic/social functioning but these associations were reduced to nonsignificance after controlling for demographics and other psychopathology symptoms. Findings provide preliminary support for the CCI, and future directions include replication with adolescents and clinical samples in order to further examine the CCI's factor structure, reliability, validity, and clinical utility.

Conservative management of small bowel perforation in Ehlers-Danlos syndrome type IV.

Ehlers-Danlos syndrome (EDS) is a group of inherited connective tissue disorders caused by collagen synthesis defects. EDS type IV, or vascular EDS, is caused by loss-of-function mutations in the type III pro-collagen gene (COL3A1). Common complications of EDS type IV include gastrointestinal bleeding and bowel perforations, posing diagnostic and therapeutic dilemmas for both surgeons and gastroenterologists. Here, we describe a complicated case of EDS type IV in a 35-year-old caucasian female who presented with overt gastrointestinal bleeding. The patient had a prior history of spontaneous colonic perforation, and an uncomplicated upper endoscopy was performed. A careful ileoscopy was terminated early due to tachycardia and severe abdominal pain, and a subsequent computed tomography scan confirmed the diagnosis of ileal perforation. The patient was managed conservatively, and demonstrated daily improvement. At the time of hospital discharge, no further episodes of gastrointestinal blood loss had occurred. This case highlights the benefit of conservative management for EDS patients with gastrointestinal hemorrhage. It is recommended that surgical treatment should be reserved for patients who fail conservative treatment or in cases of hemodynamic instability. Finally, this case demonstrates the necessity for a higher threshold of operative or endoscopic interventions in EDS type IV patients.

Semen levels of spermatid-specific thioredoxin-3 correlate with pregnancy rates in ART couples.

Spermatid specific thioredoxin-3 (SPTRX3 or TXNDC8) is a testis/male germ line specific member of thioredoxin family that accumulates in the superfluous cytoplasm of defective human spermatozoa. We hypothesized that semen levels of SPTRX3 are reflective of treatment outcome in assisted reproductive therapy (ART) couples treated by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Relationship between SPTRX3 and treatment outcome was investigated in 239 couples undergoing ART at an infertility clinic. Sperm content of SPTRX3 was evaluated by flow cytometry and epifluorescence microscopy, and correlated with clinical semen analysis parameters, and data on embryo development and pregnancy establishment. High SPTRX3 levels (>15% SPTRX3-positive spermatozoa) were found in 51% of male infertility patients (n = 72), in 20% of men from couples with unexplained, idiopathic infertility (n = 61) and in 14% of men from couples previously diagnosed with female-only infertility (n = 85). Couples with high SPTRX3 produced fewer two-pronuclear zygotes and had a reduced pregnancy rate (19.2% pregnant with >15% SPTRX3-positive spermatozoa vs. 41.2% pregnant with <5% SPTRX3-positive sperm; one-sided p<0.05). The average pregnancy rate of all 239 couples was 25.1%. Live birth rate was 19.2% and lowest average SPTRX3 levels were found in couples that delivered twins. Men with >15% of SPTRX3-positive spermatozoa, a cutoff value established by ROC analysis, had their chance of fathering children by IVF or ICSI reduced by nearly two-thirds. The percentage of SPTRX3-positive spermatozoa had predictive value for pregnancy after ART. Gradient purification and sperm swim-up failed to remove all SPTRX3-positive spermatozoa from semen prepared for ART. In summary, the elevated semen content of SPTRX3 in men from ART couples coincided with reduced incidence of pregnancy by IVF or ICSI, identifying SPTRX3 as a candidate biomarker reflective of ART outcome.